As China's population ages, there is a growing concern about the prevalence of polypharmacy among the elderly and the phenomenon of potential irrational drug use among this demographic.

To investigate the potential inappropriate medication (PIM) and potential prescription omission in the community elderly patients by three different evaluation criteria, and to provide evidence for regulating the management of drug therapy for the elderly.

From April 2021 to June 2021, this study adopted the method of cluster sampling to select Wuhan, Yichang, Qianjiang and Zhijiang in Hubei Province as sample areas. A total of 12 communities in 3 streets or towns were randomly selected from each as research units. Elderly patients in the communities who met the pre-established inclusion and exclusion criteria were selected as the research subjects. Comprehensively applying the Beers criteria (2023 edition), the Screening Tool of Older Person's Prescriptions/Screening Tool to Alert doctors to Right Treatment (STOPP/START) criteria (2014 edition), and the Chinese Criteria for Potentially Inappropriate Medication Use in Elderly People (2017 edition), the PIM and potential prescription omissions of elderly patients in the communities of Hubei Province were analyzed.

A total of 1 011 elderly patients in the community were included, among whom 420 were male patients (43.08%) and 591 were female patients (57.92%). The comparison of the number of medication types among patients of different genders, ages and types of chronic diseases showed statistically significant differences (P<0.05). PIM was detected in 294 cases (29.08%) of patients using the Beers criteria (2023 edition). Using the STOPP/START criteria (2014 edition), PIM was detected in 189 patients (18.69%), and a total of 229 cases of prescription omission occurred. According to the Chinese criteria for PIM use in elderly people (2017 edition), PIM was detected in 296 cases (29.28%) of patients. The drug with the highest frequency of PIM detected by Beers criteria (2023 edition) was fast-release nifedipine. The drug with the highest frequency of PIM was non-steroidal anti-inflammatory drugs according to STOPP/START criteria (2014 edition), and the item with the highest frequency of prescription omission was type 2 diabetes without metformin treatment. The drug with the highest PIM frequency detected by Chinese criteria for PIM use in elderly people (2017 edition) was nifedipine.

The problems of PIM and prescription omission in the course of treatment of community elderly patients should be paid attention to, and it is necessary to strengthen the drug therapy management of community elderly patients. The three criteria each other to a certain extent, enabling a more comprehensive screening of PIM and prescription omission issues.

Chronic pruritus (CP) has become a significant health problem affecting the elderly in community settings. Community health service institutions plays a crucial role in chronic disease management, but the current state of medical services for elderly patients with CP is still unclear.

This study aims to explore the current status and challenges of CP services for the elderly in community settings, and to propose actionable recommendations for enhancing the comprehensive service capabilities of general practitioners.

Between April and May 2024, semi-structured in-depth interviews were conducted with general practitioners working in Beijing community health service institutions using purposive sampling. The interview guidelines were composed of several open questions, including outpatient consultations, current service provision, challenges encountered and suggestions for service improvement. Thematic framework analysis was used to analyze the data, and findings were reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ) .

A total of 15 general practitioners were interviewed. The interview themes included 4 main themes and 19 sub-themes, which were: (1) Current status of outpatient consultations: prevalent among elderly patients, diverse etiologies and significant impacts on health; (2) Service provision: drug therapy, health education, follow-up visits and drug dispensing; (3) Existing challenges: insufficient professional knowledge, lack of high-quality training, inadequate attention to CP, low patient awareness, underutilization of clinical guidelines, limited medical resources and insufficient service promotion; (4) Improvement suggestions: establishing a standardized pruritus management process, implementing needs-based training, integrating pruritus care into existing chronic disease management programs, fostering a supportive environment, developing traditional Chinese medicine services and promoting sub-specialties development.

There is an imbalance between the supply and demand for CP services for the elderly in community health settings. To address this, the feasible methods include strengthening physician training, establishing standardized diagnostic and treatment protocols, integrating pruritus management into chronic disease management programs, and developing high-quality clinical practice guidelines in primary care.

Previous studies on "internet+health management" for the elderly mainly focused on the willingness to use mobile health applications, with less attention to the webcast exercise guidance.

Based on the unified theory of acceptance and use of technology (UTAUT) model and the perceived risk theory, we investigated the older people's willingness to use webcast exercise guidance.

From April to August 2022, a convenience sampling method was used to select older people visiting the Fangzhuang Community Health Service Center in Fengtai District, Beijing, as the subjects, and a self-designed questionnaire was conducted face-to-face. The questionnaire mainly assessed older adults' intention to use webcast exercise guidance.

A total of 390 questionnaires were distributed, and 376 valid questionnaires were collected, with a valid recovery rate of 96.4% (376/390). Of the 376 participants, 161 were men and 215 were women. The fit index of the modified UTAUT model was better than the acceptable standards, indicating a good fit. The structural equation model test results showed that, performance expectancy (β=0.424), effort expectancy (β=0.325), social influence (β=0.596), and facilitating conditions (β=0.204) had a positive impact on the elderly's intention to use webcast exercise guidance, respectively, while perceived risk (β=-0.634) had a negative impact (P<0.001) .

Based on the UTAUT model and the perceived risk theory, performance experience, effort experience, social influence, and facilitating condition all positively affect the elderly's willingness to use webcast exercise guidance, while perceived risk negatively affects the Unified theory of acceptance and use of technology; Perceived risk theoryelderly's willingness to use webcast exercise guidance.

Successful aging helps to slow the process of social aging, and there is a lack of comprehensive research on the association between health physical fitness and successful aging.

To explore the relationship between health physical fitness and successful aging among community-dwelling middle-aged and elderly adults.

A cross-sectional study was conducted among older adults aged 50 years and older in Hangzhou City. Based on the successful aging model of low risk of disease and disability, high level of physical and cognitive function, and active social engagement, 895 community-dwelling middle-aged and elderly adults of different genders were classified into the successful aging group and the unsuccessful aging group, and the differences in health physical fitness such as physical shape, physical function, and physical quality were compared between these two groups. Binary categorical Logistic regression was used to analyze the association between health physical fitness and successful aging.

Regardless of gender, the successful aging population had lower waist circumference, waist-to-hip ratio, BMI, and better lower limb strength compared to the unsuccessful aging population. The successful aging female population had lower systolic blood pressure and better endurance, balance, and upper extremity flexibility, whereas the successful aging male population had faster gait speed and better lower extremity flexibility (all P<0.05). After adjusting for age, education, visual impairment, smoking history, and alcohol consumption history, balance and lower limb strength were found to be significantly associated with successful aging in females, with corresponding ORs of 1.015 (1.003-1.028) and 1.080 (1.009-1.156), respectively. Whereas, in males, there was a significant association between lower limb strength and successful aging, with a corresponding OR of 1.119 (1.005-1.246) (P<0.05) .

Successful aging population is better than unsuccessful aging population in terms of body shape, physical function, and physical quality indicators, and the relationship between successful aging and health physical fitness varies in different genders. It is recommended to adopt appropriate health physical fitness management measures for different genders to promote the realization of successful aging.

Primary healthcare institutions play a crucial role in the management of hearing loss in the elderly. However, the available evidence is extensive and fragmented, and there is currently no scientific or standardized clinical practice guideline.

To comprehensively review and analyze the best evidence on the management of hearing loss in community-dwelling older adults within primary health care settings, providing a reference for clinical practice and guideline development.

Systematic searches were conducted in BMJ Best Practice, UpToDate, International Guideline Collaboration, Medlive.cn, National Institute for Health and Care Excellence, World Health Organization, National Guideline Clearinghouse, Canadian Medical Practice Guidelines Network, Scottish Intercollegiate Guidelines Network, Ontario Nurses Association, Joanna Briggs Institute (JBI) Collaboration Centre Library, Cochrane Library, PubMed, Web of Science, CINAHL, CNKI, Wanfang Data, and China Biomedical Literature Database. The search covered all evidence related to the management of hearing loss in older adults, including clinical decisions, guidelines, systematic reviews, and expert consensus, published between January 2014 and September 2024. The best available evidence was summarized according to the JBI Evidence-Based Healthcare Center's grading system (2016 version).

A total of 14 documents were included, consisting of 2 clinical decisions, 5 guidelines, 5 systematic reviews, and 2 expert consensus reports. 35 pieces of best evidence were identified, covering 8 key areas: clinical characteristics of hearing loss, screening, assessment, referral, support for hearing assistive devices, hearing rehabilitation training, social support and health education.

The best evidence for managing hearing loss in elderly individuals developed in this study provides evidence-based support for primary healthcare professionals, helping them manage elderly patients' hearing loss in a standardized and scientific manner, thereby improving their hearing health and overall well-being.

Sarcopenia is prone to increase the risk of hospitalization and death in elderly people, and its incidence is often higher in patients with multiple chronic diseases. Detecting comorbidities can detect and treat sarcopenia as early as possible, but previous studies have not fully considered the severity and combination of chronic diseases.

To analyze the association between age-adjusted charlson comorbidity index (aCCI) and the risk of sarcopenia in elderly patients, and explore a new predictive models for sarcopenia in the elderly.

Select 218 elderly patients who were treated at the 925th Hospital of Joint Logistics Support Force from December 2023 to May 2024. According to the diagnosis results, the patients were divided into two groups: sarcopenia group (n=69) and non-sarcopenia group (n=149). Collect basic patient information, blood biochemical indicators, muscle related indicators, Mini Nutritional Assessment Short-Form (MNA-SF), etc., and use aCCI to assess comorbidities. Using multiple Logistic regression analysis to investigate the association between aCCI and other factors with sarcopenia in elderly patients, and drawing receiver operating characteristic (ROC) curves to evaluate the predictive value of aCCI and scoring models for sarcopenia in elderly patients.

The results of multiple Logistic regression analysis showed that elevated aCCI (OR=1.661, 95%CI=1.165-2.368, P=0.005) was a risk factor for sarcopenia in elderly patients, while elevated MNA-SF score (OR=0.682, 95%CI=0.506-0.920, P=0.012) and calf circumference (OR=0.543, 95%CI=0.413-0.714, P<0.001) were protective factors for sarcopenia in elderly patients. Based on the multiple Logistic regression model equation Logit (P) =20.174-MNA-SF score×0.382 calf circumference×0.611+aCCI score×0.507, a nomogram prediction model for the risk of sarcopenia in elderly patients was constructed. The ROC curve analysis of MNA-SF score, calf circumference, aCCI, and nomogram prediction models for predicting sarcopenia in elderly patients showed that the area under the ROC curve (AUC) of MNA-SF score, calf circumference, and aCCI for predicting sarcopenia in elderly patients was 0.733 (95%CI=0.654-0.813), 0.853 (95%CI=0.797-0.908), and 0.739 (95%CI=0.662-0.815), respectively. The AUC of the nomogram prediction model for sarcopenia in elderly patients was 0.919 (95%CI=0.878-0.959, P<0.001), with an optimal cutoff value of 0.37, sensitivity of 0.831, and specificity of 0.821.

Our findings suggest that elevated aCCI is a risk factor for sarcopenia in elderly patients, while elevated MNA-SF score and calf circumference are protective factors. And the nomogram prediction model based on MNA-SF score, calf circumference, and aCCI has high predictive value for sarcopenia in elderly patients, which can provide a basis for early screening and prevention of sarcopenia.

The relationship between serum bilirubin and carotid plaque in elderly patients with type 2 diabetes mellitus (T2DM) remains unclear.

To investigate the association between serum bilirubin levels within the normal range and the risk of carotid plaque in elderly patients with T2DM, and to explore the potential underlying mechanisms.

A total of 2 885 elderly T2DM patients (aged≥65 years) with complete clinical data hospitalized in the Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine from January 2003 to December 2012 were recruited in this retrospective study. According to the quintiles of serum unconjugated bilirubin (UCB) levels, the patients were divided into five groups: Q1 (UCB<6.0 μmol/L, n=446), Q2 (UCB: 6.0-7.5 μmol/L, n=717), Q3 (UCB: 7.6-8.9 μmol/L, n=533), Q4 (UCB: 9.0-10.1 μmol/L, n=607), and Q5 (UCB>10.1 μmol/L, n=582). The detailed clinical data, physical examination findings, carotid ultrasound measurements, and laboratory test results were collected. The prevalence of carotid plaque was compared among the five groups. Partial correlation analysis was performed to examine the associations between serum C-reactive protein (CRP) and bilirubin levels. Binary Logistic regression was used to analyze the association of serum bilirubin including total bilirubin (TB), UCB, and conjugated bilirubin (CB) with the presence of carotid plaque.

Among 2 885 elderly hospitalized patients with T2DM, 1 296 were men (44.9%) and 1 589 were women (55.1%), with a mean age of 72.6±5.3 years. Significant differences were observed among the five groups with respect to age, sex, diabetes duration, smoking status, use of lipid-lowering medications, insulin or insulin analog therapy, diastolic blood pressure, and lipoprotein (a) levels (P<0.05). After adjustment for age, sex, and diabetes duration, the prevalence of carotid plaque in elderly T2DM patients across Q1 to Q5 was 76.9%, 71.8%, 68.5%, 65.9%, and 62.2%, respectively, showing a significant decreasing trend (χ²=30.900, P<0.001). Partial correlation analysis further demonstrated that serum TB (R=-0.090, P<0.001) and UCB (R=-0.100, P<0.001) were inversely correlated with CRP levels after adjustment for age, sex, and diabetes duration. After adjusting for multiple confounders, binary logistic regression analyses showed that serum TB (OR=0.833, 95%CI=0.721-0.963, P=0.013) and UCB (OR=0.831, 95%CI=0.725-0.952, P=0.008) were independently associated with a lower risk of carotid plaque in elderly patients with T2DM.

Higher serum bilirubin levels within the normal range are associated with a decreased risk of carotid plaque in elderly patients with T2DM. Lower levels of serum TB and UCB levels are independent risk factors for carotid plaque, which may be related to inflammatory status.

Against the backdrop of rapid population aging and digital transformation of health services in China, enhancing digital health literacy (DHL) has emerged as a critical determinant of healthy aging. The current elderly population generally faces a digital divide, with low levels of digital health literacy, especially in terms of obtaining, screening, and applying health information, which presents significant difficulties. It is urgent to explore scientifically effective intervention paths.

Exploring the effectiveness of online and offline training in enhancing DHL among the elderly.

In April 2024, 125 elderly people were recruited from two community hospitals in Shanghai as research subjects through physician recommendations, outpatient promotion, and ward promotion, and 120 elderly people were actually included. The participants were randomly divided into an online intervention group, an offline intervention group, and a control group using a random number table method. The offline intervention group adopted a combination of offline lectures and on-site practical Q&A. Three offline training sessions were organized, each lasting 40 minutes, for a total of 120 minutes. The online intervention group adopted a combination of watching videos and online interaction, pushing 3 training videos, 40 minutes each time, for a total of 120 minutes. The control group did not receive any intervention. Conduct online or offline DHL training on three dimensions: how to search for health resource information, how to distinguish the quality of health resource information, and how to confidently make health information decisions. Pre- and post-intervention comparisons utilized the eHEALS scale to evaluate outcomes.

Before intervention, there was no statistically significant difference in the total eHEALS scores among the three groups (P>0.05) . After intervention, there was a statistically significant difference in the total eHEALS scores among the three groups (P<0.05) , with the online group having a higher eHEALS score than the control group (P<0.05) , the offline group having a higher eHEALS score than the control group (P<0.05) , and the offline group having a higher eHEALS score than the online group (P<0.05) .

Both online and offline education can help improve the digital health literacy of the elderly, and offline education and training have better effects than online education.

Cardiovascular metabolic diseases are closely associated with depression. Although the management of cardiovascular metabolic diseases at the community level has been established, psychological issues such as depression in patients have not received sufficient attention. Moreover, there is a lack of simple, accurate, and efficient screening and assessment tools for depression.

To apply single-lead wearable electrocardiographic devices to predict the risk of depression in elderly patients with cardiovascular metabolic diseases at the community level of Ning Xia Hui Autonomous Region.

A total of 3 121 elderly patients (aged over 65) with hypertension, diabetes, coronary heart disease, and other cardiovascular metabolic diseases were selected from 20 primary medical and health care institutions in Ningxia between January 2022 and June 2023. Electrocardiographic data collected via single-lead wearable electrocardiographic devices were uploaded to a cloud platform. Additionally, sociodemographic, lifestyle, and mental health data were collected from the same platform. The data were divided into a training set (2 341 cases) and a validation set (780 cases) using a simple random sampling method at a 3∶1 ratio. LASSO regression analysis and cross-validation were performed using RStudio 4.1.1 software to identify the best predictors. A multivariable Logistic regression model was then established using the predictors selected by LASSO regression. A nomogram model for predicting the risk of depression in elderly patients with cardiovascular metabolic diseases was constructed. The model's efficacy was evaluated using the receiver operating characteristic (ROC) curve, calibration, and decision curve analysis.

In the training set, LASSO regression combined with Logistic regression analysis identified several significant factors associated with depression in elderly patients with cardiovascular metabolic diseases: gender (OR=1.747, 95%CI=1.258-2.434) , BMI (OR=1.073, 95%CI=1.024-1.125) , urban and rural areas (OR=1.684, 95%CI=1.172-2.456) , exercise (OR=0.610, 95%CI=0.460-0.799) , anxiety (OR=3.041, 95%CI=1.597-5.484) , coronary heart disease (OR=2.743, 95%CI=1.971-3.815), premature beats (OR=4.745, 95%CI=1.681-19.977) , standard deviation of average normal-to-normal Intervals (SDANN) (OR=4.745, 95%CI=1.681-19.977) , root mean square deviation (rMSSD) (OR=0.986, 95%CI=0.972-0.999) , and sleep efficiency (OR=0.988, 95%CI=0.982-0.995) . The differences were statistically significant (P<0.05) . The Logistic regression equation Logit (P) =4.322+0.558×gender+0.071×BMI+0.521×urban and rural areas-0.494×exercise+1.112×anxiety+1.009×coronary heart disease+1.557×premature beat-0.011×SDANN-0.014×rMSSD-0.012×sleep efficiency was used to construct a column chart prediction model. The area under the curve for predicting the risk of depression in elderly chronic disease patients in the training and validation sets were 0.748 (95%CI=0.707-0.786, P<0.001) , 75.2%, 63.4% and 0.751 (95%CI=0.692-0.809) , 76.7%, 60.6%, respectively. The clinical decision curve analysis showed that when the probability threshold for depression risk was between 8% and 35% in the training set and between 8% and 37% in the validation set, the net benefit of predicting the risk of depression in elderly patients with cardiovascular metabolic diseases was higher.

Gender, BMI, urban and rural areas, exercise, anxiety, coronary heart disease, premature beats, SDANN, rMSSD, sleep efficiency are contributing factors to the risk of depression in elderly patients with cardiovascular metabolic diseases. This study successfully constructed a nomogram model for predicting the risk of depression in elderly patients with cardiovascular metabolic diseases at the community level, based on single-lead wearable electrocardiographic devices. The model demonstrated good predictive efficacy and clinical application value. It can assist primary medical and health care institutions in conducting depression screening and formulating individualized intervention measures for patients, thereby aiding in the prevention and control of cardiovascular diseases at the community level.

With the accelerating trend of global population aging, intrinsic capacity has gained increasing attention as a core metric of healthy aging. Intrinsic capacity encompasses the composite of an individual's physical and mental abilities, specifically comprising five dimensions: cognition, locomotion, vitality (nutrition and metabolism), sensory (vision and hearing), and psychology. Decline in intrinsic capacity is strongly associated with adverse outcomes such as frailty, disability, falls, hospitalization, and death. Establishing a scientifically valid and effective system for the early screening and assessment of intrinsic capacity is therefore crucial for maintaining functional status in older adults and promoting healthy aging. Currently, China lacks standardized consensus on intrinsic capacity screening and comprehensive assessment protocols. To address this gap, the Chinese Geriatrics Society and the National Clinical Research Center for Geriatric Diseases (Xuanwu Hospital) spearheaded the development of this consensus. Based on evidence-based medicine and utilizing the GRADE framework for evidence grading this consensus systematically integrates the latest research. It aims to establish a scientific and standardized screening and comprehensive assessment system for intrinsic capacity, implement strategies for early identification and dynamic monitoring, and ultimately provide a reference for delaying the decline of intrinsic capacity and maintaining functional independence.

Depression belongs to the category of emotional disorders in traditional Chinese medicine, and its pathogenesis can be explained by the theory of "kidney brain harmony". Whether kidney tonifying and brain strengthening acupuncture therapy can be used to treat elderly depression has not been reported in the past.

Exploring the effect of tonifying the kidney and strengthening the brain acupuncture therapy based on the theory of "kidney brain coordination" combined with sertraline on improving the emotional and cognitive functions of elderly depression patients.

This trial has been registered with the Chinese Clinical Trial Registry (registration number: ChiCTR2400081227). Eighty-six elderly patients with depression admitted to the Department of Mental Health and Psychology of the General Hospital of Northern Theater Command between March 2023 and March 2024 were selected as the research subjects, they were randomly divided into an observation group (n=43) and a control group (n=43). The patients in the control group were treated with sertraline alone, while the patients in the observation group were treated with kidney tonifying and brain strengthening acupuncture combined with sertraline. All patients were treated for 4 weeks. Before and after treatment, evaluate depressive mood using the 17 item Hamilton Depression Scale (HAMD-17), evaluate cognitive function using the Wisconsin Card Sorting Test, detect platelet count (PLT), mononuclear cell count (MONO), neutrophil count (NC), lymphocyte count (LC), and calculate systemic immune inflammation index (SII), systemic inflammatory response index (SIRI). Compare the HAMD-17 scores, cognitive function, SII and SIRI of the two groups before and after treatment. The relationship between the change values of HAMD-17 scores and cognitive function with SII and SIRI in the observation group was analyzed by Pearson correlation analysis, and the clinical efficacy of the two groups was compared.

The HAMD-17 score in the observation group was lower than the control group after treatment (P<0.05). The percentage of correct responses and conceptualization level in the Wisconsin Card Sorting Test in the observation group after treatment was higher than that in the control group (P<0.05). The SII and SIRI of the observation group was lower than the control group after treatment (P<0.05). The changes in SII before and after treatment in the observation group were positively correlated with the changes in HAMD-17 score (r=0.536, P<0.05). The changes in SII were negatively correlated with the percentage of correct responses to the Wisconsin Card Sorting Test (r=-0.621, P<0.05) and the percentage of conceptualization level (r=-0.482, P<0.05), respectively. The change in SIRI score was positively correlated with the change in HAMD-17 score (r=0.429, P<0.05). The SIRI change values were negatively correlated with the percentage of correct responses to the Wisconsin Card Sorting Test (r=-0.378, P<0.05) and the percentage of conceptualization level (r=-0.434, P<0.05), respectively. The therapeutic effect of the observation group was better than the control group (P<0.05).

Kidney tonifying and brain strengthening acupuncture therapy can improve the effectiveness of sertraline in treating elderly depression, and its mechanism of alleviating depressive mood and cognitive function may be related to improving immune inflammation.

Acute kidney injury (AKI) on the basis of multimorbidity (also known as "geriatric comorbidity") in elderly individuals is very common in clinical practice. Early and timely intervention with rehabilitation treatment can improve the quality of life and clinical prognosis of patients. This guideline aimed to guide clinical and rehabilitation experts to provide guidance for the implementation of rehabilitation for elderly patients with comorbidity and AKI.

The problem of population aging in China is becoming increasingly prominent, and the health of the elderly has become an important issue.

To analyse the current situation of establishing health records for the elderly and explore the impact of establishing health records on their medical behavior.

Using he latest released 2020 Chinese Longitudinal Aging Social Survey (CLASS). This database contains a total of 11 398 samples. After removing missing value samples of core variables, a valid sample of 11 381 was obtained. The propensity score matching (PSM) method was used to match the elderly with or without established health records, univariate and unordered multiclass regression analyses were conducted. The dependent variable is the medical behavior of the elderly (choosing not to seek medical treatment, using regular medicine and buying medicine from pharmacies were classified as self treatment which assigned a value of 0, choosing specialized/comprehensive hospitals was assigned a value of 1 and choosing village clinics/community hospitals was classified as primary healthcare institutions which assigned a value of 2). The independent variable was whether health records have been established in the community healthcare institution. The control variables included residential area, gender, age, marital status, self-rated health, chronic disease status, hospitalization frequency within two years, utilization of elderly care services and education level.

After PSM, a total of 1 244 pairs were successfully matched, a total of 2 488 participants. The results of the univariate analysis showed that there was no statistically significant difference (P>0.05) between the general situation of the study subjects who established health records and those who did not with 1 224. The regression results showed that compared with self treatment, establishing health records was a promoting factor for the elderly to seek medical treatment in specialized/comprehensive hospitals (OR=2.596, 95%CI=2.024-3.330, P<0.05) and primary healthcare institutions (OR=1.774, 95%CI=1.484-2.122, P<0.05).

The elderly who establish health records exhibit positive medical seeking behavior. Therefore, we need to increase efforts to carry out the construction of health records for the elderly, regularly carry out health education lectures.Taking advantage of the positive role of family doctor contract services and based on the health service demands and health levels of the contracted elderly, which regularly release health record related knowledge, continuously enhance the elderly's awareness of self health management and guide them to form good medical habits.

The CAPDCA Model of Personalized Patient Education is a new individualized health education model, and its effectiveness has been fully confirmed by theoretical and clinical verification. This model puts forward feasible solutions for the problems existing in the current clinical implementation of health education, such as content fragmentation; inability to large-scale individualization; lack of comprehensive and continuous management; lack of doctor-patient shared decision-making and continuous improvement. This model is suitable for chronic disease patients with poor compliance and poor effect of traditional health education management. In order to describe the application method of this model in detail, this article shows the specific process of the application of this model in the management of an elderly diabetic patient with poor blood glucose control, and explains each step in detail. After the intervention by CAPDCA Model of Personalized Patient Education, the patient's blood glucose was gradually stabilized and reached the target levels of treatment, medication compliance was improved, personal quality of life was improved, and self-management ability of diabetes was enhanced. CAPDCA Model of Personalized Patient Education can provide a new method for individualized health education of diabetic patients and improve the effect of health education. This model is suitable for further promotion and application in clinical institutions.

To prevent poverty due to illness, identifying the risk factors of health poverty vulnerability is crucial. In the rural areas of Xinjiang, there are many elderly patients with chronic diseases due to the geographical environment and dietary habits. Xinjiang rural areas are also the regions with relatively slower economic development in Xinjiang, so it is urgent to build an evaluation index system for identifying the high poverty vulnerability of elderly chronic disease patients in Xinjiang rural areas.

To explore the construction of an evaluation index system suitable for elderly chronic disease patients in rural areas of Xinjiang, with the aim of providing theoretical basis for precision poverty alleviation and taking targeted preventive measures in the future.

From December 2023 to February 2024, a preliminary evaluation index pool for the health poverty vulnerability of elderly chronic disease patients in Xinjiang's agricultural and pastoral areas was constructed through literature review; We conducted three rounds of expert consultation using the Delphi method from March to April 2024, and finally calculated the weight values of various indicators using the Analytic Hierarchy Process.

After three rounds of expert inquiries, the indicator system was modified and improved, and the final constructed indicator system includes three primary indicators, six secondary indicators, and 37 tertiary indicators. The first round of expert positivity coefficient was 92%, authority coefficient was 0.876, and Kendall's W coefficients for various indicators were 0.264, 0.395, and 0.365, respectively; In the second round, the expert's positive coefficient was 84%, the authority coefficient was 0.900, and the Kendall's W coefficients for various indicators were 0.273, 0.403, and 0.370, respectively; The positivity coefficient of the third expert is 84%, the authority coefficient is 0.905, and the Kendall's W coefficients for various indicators are 0.301, 0.466, and 0.412, respectively.

The evaluation index system for the health poverty vulnerability of elderly chronic disease patients in Xinjiang's agricultural and pastoral areas, based on the framework of "health stressors health risks health security" based on resilience theory, has certain innovation and practicality.

Frailty was an age-related geriatric syndrome, with its prevalence among Chinese older adults being notably high and demonstrating a rising trend over time. Obesity was closely associated with the development of numerous diseases, but its relationship with frailty remained controversial. This uncertainty was potentially attributable to limitations of conventional obesity indicators in characterizing adipose tissue distribution. Therefore, investigating the associations between multiple adiposity metrics and frailty was important for to advance the understanding of frailty pathogenesis and developing preventive interventions.

This study investigates the relationship between various obesity indicators and frailty, providing a scientific basis for the early prevention and control of frailty in older adults.

In this study, a total of 1 429 elderly people aged 60 years and above were surveyed in six rural villages in Jingyuan County, Gansu Province, from March to May 2023. After further exclusions, a final sample of 1 153 participants was included in the analysis. The FRAIL scale was utilized to assess the frailty status of the elderly. Based on Chinese obesity criteria, waist circumference and BMI were categorized, and waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body roundness index (BRI), and Chinese visceral adiposity index (CVAI) were grouped by quartiles. Multivariate Logistic regression, restricted cubic splines, and receiver operating characteristic (ROC) curve analysis were employed to explore the relationship between different obesity indicators and frailty.

This study included 1 153 elderly participants aged≥60 years, comprising 474 males (41.11%) and 679 females (58.89%), with a mean age of 70.86±4.76 years. Based on FRAIL scale assessments, 226 participants were identified as frail and 927 as non-frail, resulting in a frailty prevalence of 19.60%. The adjusted multivariate Logistic regression analysis revealed that central obesity, moderate to severe obesity (reference: normal BMI), Q3 and Q4 (reference: Q1) levels of WHR, and Q4 (reference: Q1) levels of WHtR, BRI, and CVAI were significant risk factors for frailty in the elderly population (P<0.05), with progressively increasing risks of frailty associated with elevated levels of waist circumference, BMI, WHR, WHtR, BRI, and CVAI (P_trend<0.05). The restricted cubic spline (RCS) curve indicated that waist circumference, BMI, WHtR, BRI, and CVAI were linearly and positively correlated with the risk of frailty in the elderly (P_linear<0.05). The ROC curve analysis demonstrated that that the predictive capacity for frailty in the elderly was possessed by waist circumference, BMI, WHR, WHtR, BRI, and CVAI, with area under the curve (AUC) of 0.557 (95%CI=0.515-0.598), 0.570 (95%CI=0.528-0.612), 0.558 (95%CI=0.515-0.600), 0.610 (95%CI=0.568-0.652), 0.610 (95%CI=0.568-0.652), and 0.586 (95%CI=0.546-0.626), respectively (P<0.05). Additionally, WHtR, BRI, and CVAI demonstrated better predictive ability compared to waist circumference (Z=-5.443, P<0.001; Z=-5.443, P<0.001; Z=-2.595, P=0.009), and both WHtR and BRI showed better predictive ability compared to BMI (Z=-2.885, P=0.004; Z=-2.884, P=0.004).

In rural regions, among the elderly population aged 60 and above, obesity indicators such as waist circumference, BMI, WHR, WHtR, BRI, and CVAI were positively correlated with the risk of frailty in the elderly. Among these indicators, WHtR and BRI showed better predictive ability for frailty.

Fall is one of the most common and serious problems in the elderly, and fall efficiency is an important influencing factor. There are various exercise ways to improve fall efficiency in the elderly, and the merits and demerits of various exercise intervention effects are still uncertain.

To compare the effects of different exercise modes on fall efficacy in the older people, aiming to provide a reference for patients to choose the best exercise mode.

A literature search was conducted in databases such as China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP, SinoMed, PubMed, CINAHL, Web of Science, Embase, Cochrane Library, and FMRS to identify relevant studies on the effectiveness of exercise in reducing falls among the elderly. The search period was from the establishment of the databases to August 15, 2025. The outcome measures were the Falls Efficacy Scale-International (FES-I), Berg Balance Scale (BBS), and Timed Up and Go Test (TUGT). The Cochrane bias assessment tool was used to evaluate the quality of the literature. Stata 18 software was used to perform a network meta-analysis, and the surface under the cumulative ranking curve (SUCRA) was used to rank the effectiveness of different treatment regimens.

A total of 35 studies were included in this study, involving 2, 627 subjects and 13 types of exercise. In terms of fall efficacy, Otago (MD=8.94, 95%CI=3.51-14.38), Tai Chi (MD=9.24, 95%CI=4.96-13.51), step marching exercise (MD=8.60, 95%CI=2.56-14.64) and pilates (MD=6.86, 95%CI=1.19-12.53) were more effective than the usual care group (P<0.05), with Tai Chi having the highest likelihood of being the most effective intervention (SUCRA=81.2). In terms of balance function, Otago (MD=3.87, 95%CI=2.71-5.02), Tai Chi (MD=3.87, 95%CI=1.71-6.03), and resisted + balance training (MD=3.26, 95%CI=0.53-6.00) were more effective than the usual care group (P<0.05), with Otago having the highest likelihood of being the most effective intervention (SUCRA=68.1). In terms of mobility, Otago (MD=3.90, 95%CI=2.77-5.04), Tai Chi (MD=4.44, 95%CI=3.50-5.39), Baduanjin (MD=2.25, 95%CI=1.47-3.02), Baguazhang (MD=2.35, 95%CI=1.26-3.43), Gait balancing enercises (MD=3.60, 95%CI=2.15-5.05) were more effective than the usual care group (P<0.05), with Tai Chi having the highest likelihood of being the most effective intervention (SUCRA=95.0).

This study indicates that Tai Chi and Otago exercises are effective in improving fall efficacy, balance function, and mobility in older adults. Clinical healthcare professionals should select appropriate exercise methods based on the health status and needs of older adults to enhance fall efficacy, effectively prevent falls, and promote patient health. Meanwhile, further high-quality researches are needed to validate these findings.

Prioritizing health as a core development strategy highlights its importance as a key indicator of modernization and well-being. Improving the health-related quality of life (HRQoL) of rural older adults, especially those with multiple chronic diseases, aligns with a people-centered development approach. However, the specific livelihood capitals influencing their HRQoL remain unclear.

To assess the HRQoL of rural older adults with different chronic disease profiles and analyze the impact of livelihood capitals on their HRQoL.

A multi-stage stratified random sampling method was used to survey 1 900 rural residents aged ≥60 years in Zhejiang, Chongqing, and Gansu provinces from July to August 2023. HRQoL was measured using the EQ-5D-3L scale. Livelihood capitals included social capital (social participation frequency), human capital (education level, employment status), financial capital (annual income, medical insurance type), digital capital (internet usage frequency), and psychological capital (life satisfaction, expectations, and self-confidence). HRQoL utility values were compared among older adults without chronic diseases, those with a single chronic disease, and those with multimorbidity. Multiple linear regression was used to explore the influence of livelihood capitals on HRQoL across groups.

A total of 1 419 valid responses were collected (effective response rate: 74.68%). Among them, 517 (36.43%) had no chronic diseases (utility value: 0.91±0.13), 640 (45.10%) had a single chronic disease (utility value: 0.87±0.16), and 262 (18.46%) had multimorbidity (utility value: 0.80±0.19), with significant differences among the groups (P<0.05). Regression analysis showed that for those without chronic diseases, employment status (human capital), internet use frequency (digital capital), and life expectations (psychological capital) were significant factors (P<0.05). For those with a single chronic disease, social participation (social capital), employment (human capital), internet use (digital capital), life satisfaction, and self-confidence (psychological capital) influenced HRQoL (P<0.05). For those with multimorbidity, social participation, medical insurance type (financial capital), internet use, and self-confidence were key factors (P<0.05).

HRQoL decreases with the increase of the number of chronic diseases.It is necessary to explore and utilize the advantages of livelihood capital to improve the HRQoL of rural elderly.

Type 1 diabetes mellitus (T1DM) predominantly affects adolescents, drawing substantial research focus. Conversely, older adults with T1DM receive relatively little attention and research. Consequently, disease burden data for this population are scarce and urgently require filling.

To assess the disease burden and projected trends of T1DM among the elderly (age≥60 years) from 1990 to 2021, thereby providing essential evidence for public health decision-making.

Data on the incidence and disability-adjusted life years (DALYs) associated with T1DM in the elderly were extracted from the Global Burden of Disease (GBD) 2021 database from 1990 to 2021, focusing on globally, China, and five sociodemographic index (SDI) regions. Taking the GBD 2021 standard population as the reference, age-standardized incidence and DALY rates for elderly individuals with T1DM were calculated based on the direct standardization method. The trend of disease burden was analyzed via Joinpoint regression, with results reported as average annual percent change (AAPC). Subgroup analyses stratified the disease burden by age and sex, respectively. Additionally, a three-factor decomposition method was employed to dissect the relative influences of aging, population growth, and epidemiological change on the shifts in disease burden. Finally, a Bayesian model was utilized to forecast the disease burden of elderly T1DM from 2022 to 2040.

In 2021, the global and Chinese incidence of T1DM stood at 42 330 and 3 049 cases, respectively, representing increases of 199.47% and 427.50% compared to 1990. The total DALYs of the elderly T1DM reached 659 117 person-years globally and 57 663 person-years in China in 2021, marking increases of 91.80% and 78.25%, respectively, since 1990. Age-standardized DALYs rate exhibited a downward trend globally and within China from 1990 to 2021, with statistically significant differences (P<0.001). The proportion of T1DM incidence cases was highest in the 60-64 age group globally, in China, and across the five SDI stratified regions. The proportion of incidence cases in Chinese 60-64 age group (27.91%) fell between the high-middle SDI region (26.01%) and the middle SDI region (30.26%), but the proportion of DALYs among Chinese T1DM patients in the 60-64 age group (24.06%) was lower than that of all other regions. Notably, individuals aged 60-69 years constituted 53.51% of all elderly T1DM patients in China, and accounting for 55.25% of total DALYs. Population growth emerged as the primary contributing factor, responsible for 58.34% of the increase in T1DM incidence among the elderly in China. Furthermore, it was identified as the decisive factor driving DALYs increases, contributing to 178.96%. Projections indicate a continued rise in both incidence and DALYs for elderly T1DM patients globally and in China from 2022 to 2040, with a more gradual change in DALYs observed among Chinese women compared to men.

The incidence of T1DM and the associated DALYs burden in the elderly remain substantially high both globally and in China. This underscores the urgent need for the formulation and implementation of more scientifically informed and effective public health policies and clinical intervention strategies to address this pressing health challenge.

The aging process in China is accelerating, and the number of older adults with chronic diseases is increasing. The association between hypertension, along with its comorbidities, and dementia in older adults requires further investigation.

To investigate the association between hypertension, its comorbidities, and dementia in community-dwelling older adults, and to provide evidence for dementia prevention.

This study utilized cross-sectional data from 14 732 individuals aged ≥65 years from the China Multicenter Dementia Survey (CMDS, 2018-2023). Data on sociodemographic characteristics, chronic diseases, and cognitive function were collected. We employed a multivariate Logistic regression model to analyze the association between hypertension and its comorbidities and dementia in the total population and different age and sex groups.

Among the 14 732 older adults (≥65 years), 8 293 (56.3%) had two or more comorbidities, and 7 786 (52.9%) had hypertension along with other comorbidities. Of these hypertensive individuals, the numbers with 1, 2, 3, and 4 comorbidities were 2 569 (17.4%), 2 064 (14.0%), 1 018 (6.9%), and 443 (3.0%), respectively. Dementia was identified in 1 111 participants (7.5%). After adjusting for covariates, multivariate Logistic regression results showed that the risk of dementia in the hypertension-only group was 1.516 times (95%CI=1.014-2.267, P=0.042), and the risk of dementia among those with hypertension and 1 to 4 comorbidities was 1.879 times (95%CI=1.312-2.692, P=0.001), 2.071 times (95%CI=1.428-3.004, P<0.001), 2.338 times (95%CI=1.612-3.392, P<0.001), 2.591 times (95%CI=1.634-4.108, P<0.001). The highest risk of dementia was observed in individuals with hypertension coexisting with cerebrovascular disease (OR=2.550, 95%CI=1.384-4.700, P=0.003). In analyses stratified by sex and age, the risk of dementia increased significantly with the number of hypertension comorbidities (P<0.05). The strongest association was observed for hypertension coexisting with cerebrovascular disease, with adjusted odds ratios of 2.842 (95%CI=1.095-7.375, P=0.032) in men and 2.348 (95%CI=1.060-5.203, P=0.036) in women. In the group aged <75 years, the highest risk was observed for hypertension coexisting with diabetes (OR=2.833, 95%CI=1.046-7.675, P=0.041), while in the group aged≥75 years, the highest risk was observed for hypertension coexisting with cerebrovascular disease (OR=2.707, 95%CI=1.168-6.273, P=0.020). Among participants with hypertension and two comorbidities, the highest dementia risk was observed in those with coexisting heart disease and cerebrovascular disease (OR=3.559, 95%CI=1.338-9.468, P=0.011). Similarly, among those with hypertension and three comorbidities, the highest prevalence of dementia was observed in individuals with coexisting heart disease, cerebrovascular disease, and autonomic dysfunction (OR=3.881, 95%CI=1.736-8.677, P=0.001).

The prevalence of hypertension and its comorbidities is high among Chinese older adults. Patients with hypertension and its comorbidities have a significantly elevated risk of dementia, which varies by age and sex. These findings underscore the importance of optimized management of chronic diseases in this population. Implementing tailored prevention and treatment strategies based on individual characteristics could contribute to reducing the risk of dementia.

Cardiovascular diseases (CVD) are a leading cause of death both in China and worldwide. Social isolation and loneliness are closely associated with cardiovascular health. However, current research has mainly focused on European populations, and the findings are inconsistent. In China, evidence simultaneously examining the impact of social isolation and loneliness on the risk of incident CVD remains limited.

To investigate the independent and joint associations of social isolation and loneliness with the risk of CVD among middle-aged and older Chinese populations.

This prospective study, initiated in August 2024, included 10 668 participants from the China Health and Retirement Longitudinal Study who were free of heart disease and stroke at baseline. Social isolation and loneliness were assessed using baseline questionnaires. Incident CVD events were identified based on follow-up survey data. Cox proportional hazards regression models were used to estimate the associations between social isolation, loneliness, and CVD risk.

During a median follow-up of 8.9 years, 2 409 (22.58%) participants developed CVD, including 1 777 cases (16.66%) of heart disease and 896 cases (8.40%) of stroke. The Cox proportional hazards regression analysis showed that, after adjustment for multiple confounders, compared to non-lonely individuals, lonely individuals had a 24% increased risk of CVD (HR=1.24, 95%CI=1.13-1.35), a 24% increased risk of heart disease (HR=1.24, 95%CI=1.12-1.38), and a 26% increased risk of stroke (HR=1.26, 95%CI=1.09-1.45). Compared to non-socially isolated individuals, socially isolated individuals had a 16% increased risk of stroke (HR=1.16, 95%CI=1.01-1.33), but show no significant association was found between social isolation and the risk of CVD or heart disease (P>0.05). No significant interaction was observed between social isolation, loneliness, and the risk of CVD or its subtypes (P>0.05). Participants who experienced both social isolation and loneliness had the highest risk of CVD (HR=1.23, 95%CI=1.09-1.39), particularly for stroke (HR=1.49, 95%CI=1.23-1.80).

Subjectively perceived loneliness is an independent risk factor for the incidence of CVD and its subtypes, with the highest risk observed when loneliness coexists with objectively assessed social isolation. The findings of this study suggest that encouraging middle-aged and older adults to maintain active social connections and alleviate feelings of loneliness play an important role in promoting cardiovascular health.

With the acceleration of population aging, there has been a continuous increase in the number of elderly individuals suffering from multiple chronic conditions and impaired activities of daily living (ADL), imposing a substantial healthcare burden on society. While multiple chronic conditions are highly associated with impairment in ADL, the specific mechanisms and combinatorial effects have not been fully elucidated.

This study aims to analyze the current status of multiple chronic conditions among the elderly in China and explore the association between different comorbidity combinations and ADL, thereby providing scientific evidence for chronic diseases management and functional maintenance in older adults.

Utilizing data from the 2018 China Health and Retirement Longitudinal Study (CHARLS), this study focused on individuals aged 60 years and older to compare the prevalence of impaired ADL across demographic subgroups. The Apriori algorithm was employed to perform association rules analysis to identify primary comorbidity combinations. Binary Logistic regression models were used to assess the impact of these comorbidity combinations on ADL impairment.

The study included 10 999 elderly participants, and the prevalence of multiple chronic conditions was 64.91% (7 140/10 999). 3 819 individuals (34.72%) exhibited ADL impairment, 1 149 (10.45%) demonstrated basic activities of daily living (BADL) impairment, and 3 662 (33.29%) showed instrumental activities of daily living (IADL) impairment. Statistically significant differences (P<0.05) in ADL, BADL and IADL impairment rates were observed across gender, age, education level, marital status, type of residence, and the presence of multiple chronic conditions (P<0.05). The Apriori algorithm identified 8 association rules, with the highest support rule being "dyslipidemia and hypertension" (support=8.237%), the highest confidence rule being "dyslipidemia, diabetes or high blood sugar and hypertension" (confidence=78.707%), and the highest lift rule being "asthma and chronic pulmonary diseases" (lift=4.188). Hypertension exhibited the highest frequency across all comorbidity combinations. Adjusted binary Logistic regression revealed that, multiple comorbidity combinations "stroke and hypertension" "asthma and chronic pulmonary diseases", and "kidney disease, stomach or other digestive diseases, and arthritis or rheumatism" significantly impacted ADL, BADL, and IADL impairment (P<0.05). Notably, the "stroke and hypertension" combination posed the highest risk for BADL impairment, the risk of being one level more severely impaired in BADL for individuals with this comorbidity combination was 4.480 times higher than that of the population without this comorbidity combination (OR=4.480, 95%CI=3.754-5.347).

Hypertension serves as a central hub in elderly comorbidities networks, demonstrating strong associations with multiple chronic conditions. Multiple comorbidity combinations significantly increase the risk of ADL impairment, with the "stroke and hypertension" combination being the most pronounced. Healthcare systems should prioritize elderly populations with comorbidities, develop effective long term care policies tailored to different comorbidities, reduce the risk of disability, delay functional decline, and enhance quality of life in elderly population.

The global rise in the prevalence of type 2 diabetes mellitus (T2DM) among the elderly has emerged as a significant public health concern. T2DM is known to exert detrimental effects on cognitive function. However, there remains a lack of simple and effective indicators for the early detection and monitoring of this condition, highlighting an urgent need for further investigation. The present study utilizes real-world cross-sectional data to explore the disease from the perspective of "physical disease-related adjustable constitution" offering potential clinical value for the diagnosis and treatment.

To investigate the prevalence of type 2 diabetes mellitus with mild cognitive impairment (MCI) among the elderly in the Sichuan region, and to identify the factors influencing its occurrence.

Elderly patients aged ≥60 years with type 2 diabetes mellitus were selected for the survey conducted from November 2021 to November 2023. The participants were recruited from various communities and three nursing homes across six cities in Sichuan Province, namely Chengdu, Deyang, Bazhong, Emeishan, Meishan, and Mianyang. A face-to-face survey was administered using a paper-based questionnaire, which collected basic demographic information, the Changsha version of the Montreal Cognitive Assessment (MoCA), and the Traditional Chinese Medicine constitution assessment. Univariate analysis, followed by multifactorial Logistic regression, was performed to identify potential independent factors influencing the occurrence of type 2 diabetes mellitus with MCI. Pearson correlation analysis was used to explore the correlation between different cognitive domains and yang deficiency constitution.

A total of 407 questionnaires were distributed, of which 397 were valid, yielding a response rate of 97.54%. Among the 397 participants, 348 (87.7%) were elderly individuals residing in communities, and 49 (12.3%) were from nursing homes. A total of 84 participants were identified with MCI, resulting in a prevalence of 21.2% for T2DM with MCI. Based on cognitive status, participants were divided into two groups: those with T2DM and MCI (n=84) and those with T2DM without MCI (n=313). Statistically significant differences were observed between the two groups in terms of education level, depression, reading books and newspapers, as well as Traditional Chinese Medicine (TCM) constitutions including qi deficiency, yang deficiency, phlegm-dampness, and damp-heat (P<0.05). Multivariate Logistic regression analysis identified educational level (junior high school: OR=0.487, 95%CI=0.253-0.939; university and above: OR=0.149, 95%CI=0.034-0.659) and a yang deficiency constitution (OR=2.284, 95%CI=1.220-4.279) as independent risk factors for MCI in elderly patients with T2DM (P<0.05). The results of the correlation analysis showed that the score of the yang deficiency constitution score was negatively correlated with the delayed memory domain score of cognitive function (r=-0.106, P<0.05).

The prevalence of MCI among elderly patients with type 2 diabetes mellitus in Sichuan Province is 21.2%. Low educational attainment and a yang deficiency constitution are significant risk factors for the development of MCI in this population. In line with the Traditional Chinese Medicine theory that constitution can be differentiated, constitution is related, and constitution can be adjusted, early identification and targeted intervention for yang deficiency constitution may help mitigate the progression of cognitive impairment in patients with diabetes.

The risk factors leading to acute kidney injury (AKI) in elderly patients with severe pneumonia have not yet been fully clarified.

To investigate the association between the blood pressure response index (BPRI) and the incidence of AKI in elderly patients with severe pneumonia-induced shock.

A retrospective cohort study was conducted to collect clinical data from patients with severe pneumonia-induced shock admitted to the Second People's Hospital of Changzhou between 2016 and 2024. The clinical data of patients were systematically extracted from the hospital's electronic medical record system. BPRI was calculated as mean arterial pressure divided by the vasoactive-inotropic score. Document the incidence of AKI following hospitalization and the 30-day survival rate. Multivariate Logistic regression analysis was performed to evaluate the risk value of BPRI for AKI development. Receiver operating characteristic (ROC) curves were constructed to assess the predictive accuracy of BPRI for AKI, with the area under the curve (AUC) indicating the strength of prediction. Kaplan-Meier survival curves were used to analyze 30-day mortality among patients stratified by AKI risk, with differences tested using the Log-rank test.

A total of 237 patients were included in the study, of whom 96 (40.5%) developed AKI. Multivariate Logistic regression analysis revealed that elevated BPRI was a protective factor against AKI development (OR=0.751, 95%CI=0.678-0.831, P<0.001), increased lactate (OR=1.239, 95%CI=1.039-1.477, P=0.017) and elevated SOFA scores (OR=1.930, 95%CI=1.497-2.488, P<0.001) were identified as risk factors for AKI development. ROC curve analysis demonstrated that the AUC of BPRI for predicting AKI in patients with severe pneumonia-induced shock was 0.809 (95%CI=0.752-0.865), with a cutoff value of 10.063. Patients were stratified into high-risk (BPRI≥10.063, n=79) and low-risk (BPRI<10.063, n=158) groups for AKI development based on the BPRI cutoff value. Kaplan-Meier analysis demonstrated significantly lower 30-day cumulative survival rates in the high-risk AKI group compared to the low-risk group (χ²=35.310, P<0.001).

Elevated BPRI serves as a protective factor against AKI development in patients with severe pneumonia-induced shock and exhibits excellent predictive performance for AKI occurrence.

With the intensification of population aging in China, the issue of frailty among the elderly is becoming increasingly prominent, making research on its prevention and intervention particularly important. Currently, most studies lack discussion on the dynamic relationship between changes in physical activity and frailty.

This study is based on the five waves of data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020, aiming to explore the association between physical activity changes trajectories and frailty in older adults, and to provide a scientific basis for the prevention and intervention of frailty in the elderly.

Group-based trajectory modeling (GBTM) was used to identify the potential subgroups and trajectory characteristics of physical activity over time among the survey participants during the follow-up period. Multivariate unconditional logistic regression models were employed to analyze the association between different physical activity trajectory types and frailty, as well as subgroup analyses.

The physical activity trajectories of the survey participants were divided into four groups: persistent low group (262 individuals, 13.87%), low-to-increasing group (993 individuals, 52.57%), high-to-decreasing group (122 individuals, 6.46%), and persistent high group (512 individuals, 27.10%). There were significant differences in frailty among the four groups (χ²=20.867, P<0.001). After adjusting for confounding factors such as age and gender, multivariate unconditional Logistic regression indicated that compared with the persistent low group, the low-to-increasing group (OR=0.581, 95%CI=0.414-0.815, P=0.002) and the persistent high group (OR=0.546, 95%CI=0.373-0.799, P=0.002) had significantly lower risks of frailty. Subgroup analysis revealed that, compared with the consistently low group, the initially low then rising group demonstrated significant reductions in frailty risk among the following elderly subgroups: age≥65 years (OR=0.502, 95%CI=0.345-0.730), males (OR=0.539, 95%CI=0.326-0.891), urban residents (OR=0.441, 95%CI=0.211-0.922), those without a partner (OR=0.312, 95%CI=0.160-0.606) (P<0.05). Similarly, the consistently high group exhibited protective effects against frailty in elderly individuals aged≥65 years (OR=0.425, 95%CI=0.274-0.658), females (OR=0.539, 95%CI=0.328-0.886), urban residents (OR=0.280, 95%CI=0.101-0.780), and those without a partner (OR=0.347, 95%CI=0.164-0.737) (P<0.05).

Different trajectory groups are associated with the risk of frailty. Physical activity trajectories characterized by a low-to-increasing pattern and persistent high levels can significantly reduce the incidence of frailty in older adults.

Sarcopenia is an age-related geriatric syndrome characterized by decreased muscle mass, reduced muscle strength, and/or impaired physical function. It is closely associated with adverse health outcomes such as frailty, falls, fractures, disability, and even death. In community-dwelling populations, sarcopenia often presents in early or subclinical stages, making it easy to overlook and resulting in missed opportunities for timely intervention. Standardized screening for sarcopenia among older adults in the community is of great significance for early detection, targeted intervention, delaying functional decline, preventing and mitigating disability, reducing healthcare costs, and responding to the challenges of an aging society. However, there is currently a lack of evidence-based expert consensus on community-based sarcopenia screening for older adults in China. To bridge the gap, the China Rehabilitation Science Institute, Community-Based Rehabilitation Committee of the China Association of Rehabilitation of Disabled Persons, Geriatric Rehabilitation Committee of Chinese Association of Geriatric Research, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences) /Southern Medical University and the Guangzhou Association of Rehabilitation Medicine led the development of this consensus. Using the Delphi method to form a list of key questions and recommendations, the GRADE system to assess the quality of evidence and strength of recommendations, and the RIGHT checklist to standardize reporting, a total of 14 evidence-based recommendations were established. This expert consensus on community-based sarcopenia screening in older adults provides a scientific and feasible screening pathway, supports the construction of an early detection, early identification, and early intervention system for sarcopenia prevention and control in the community, and ultimately aims to improve the health and quality of life of the older population.

Hypertension is a major chronic disease managed by primary healthcare institutions in China. Cardiac autonomic dysfunction is a key cause of blood pressure regulation imbalance and adverse cardiovascular events. Therefore, in primary healthcare institutions, the use of efficient and portable single lead wearable electrocardiogram (ECG) devices can help explore the relationship between elderly hypertensive patients and the autonomic nervous system, providing a simple, efficient, low-cost, and sustainable suitable method and objective basis for the management and prevention of cardiovascular disease in primary hypertensive patients.

To investigate the correlation between the duration of hypertension and autonomic nervous system damage in elderly patients in Primary Care institutions in the Ningxia Hui Autonomous Region using a single lead wearable ECG device.

A total of 2 137 elderly hypertension patients aged 65 years or older from 20 primary medical institutions in the Ningxia Hui Autonomous Region were enrolled in this study. ECG data of 72 hours, along with basic information, psychological health, and lifestyle data, were collected and uploaded to the cloud platform using a single-lead wearable ECG device from January 2022 to December 2022. Based on the heart rate variability (HRV) time-domain parameter standard deviation of all sinus rhythm RR intervals (SDNN), subjects were divided into two groups: a normal group (SDNN>100ms, n=470) and an abnormal group (SDNN<100 ms, n=1 667). Propensity score was used to match subjects on a 1∶1 basis, adjusting for confounding factors with a caliper value of 0.02, and the matching effect was verified using inverse probability weighting. Single-factor and multivariate Logistic regression analyses were conducted to investigate the relationship between the onset of hypertension and autonomic nerve damage, and the matching effect was further verified. Subgroup analyses were performed using propensity score matching based on the onset of hypertension and autonomic nerve damage, with sensitivity analyses conducted before and after matching. Additionally, a nonlinear association between the duration of hypertension and autonomic nerve damage was examined using restricted cubic splines (RCS) analysis to test interaction effects.

Among the patients, 479 had grade 1 hypertension, and 1 658 had grade 2 hypertension. Disease duration was categorized as follows: 1 203 patients had less than 5 years of disease duration, 753 had 5-<10 years, 110 had 10-<15 years, 41 had 15-<20 years, 26 had 20-<30 years, and 4 had more than 30 years. The multivariate Logistic regression analysis showed that the relationship between autonomic nerve damage and hypertension duration was positive after matching (P<0.001). Subgroup analysis showed that the relationship between hypertension duration and autonomic nerve damage was stronger in the 80-year-old and younger, lower-educated, no comorbidities of coronary heart disease, female, and those with obstructive sleep apnea (OSA) subgroups before and after matching, with statistically significant differences (P<0.05) and interaction effects (P<0.05). However, the RCS analysis showed no nonlinear relationship between the course of hypertension and autonomic nerve damage in matched patients.

There was a positive correlation between the course of hypertension and autonomic nerve damage in elderly hypertension patients from the primary healthcare centers of the Ningxia Hui Autonomous Region. Primary healthcare facilities should strengthen health education for patients to improve their treatment adherence, which can delay autonomic nerve damage in hypertensive patients.

The prevalence of hypertension is high and the control rate is low. It is also a basic disease of comorbidity in the elderly. However, previous studies have mainly focused on the comorbidity of the elderly, and less consideration has been given to studying the comorbidity based on hypertension. Therefore, understanding the comorbidity of hypertension in urban and rural elderly is of great significance for the management of elderly patients with hypertension at the grass-roots level.

In order to understand the current situation and influencing factors of comorbidity in urban and rural elderly hypertension patients in Anshun City, and to improve the management strategy for elderly hypertension patients comorbidity in urban and rural areas.

The elderly hypertension patients who participated in physical examination in primary medical and health institutions in Anshun City in 2023 were selected as the research objects. After variable screening and transformation, missing values and outliers processing, 44 571 samples were finally included in the analysis. Demographic characteristics were selected from the basic information of elderly hypertension patients, including age, gender, marital status, etc. Behavioral habits and existing major health problems were collected from physical examination data. Apriori algorithm was used to mine common comorbidity patterns, and multi-classification Logistic regression analysis was used to explore the influencing factors.

A total of 44 571 valid samples were included, including 19 270 (43.23%) in urban and 25 301 (56.77%) in rural areas. There were statistically significant differences in the number of comorbidities among elderly hypertension patients in urban and rural areas, different genders, age groups, exercise status, smoking status, drinking status, medication status, medication compliance, and different educational levels (P<0.001). The comorbidity rate of elderly hypertensive patients in Anshun City was 70.44% (31 397 cases), of which the urban comorbidity rate was 74.45% (14 346 cases) and the rural comorbidity rate was 67.39% (17 051 cases). The co-morbidity patterns of urban and rural males and females were mainly "obesity + hypertension, dyslipidemia + hypertension, obesity + dyslipidemia + hypertension". The support of "obesity + hypertension" in urban areas is much higher than that in rural areas, while the support of "anemia + hypertension" in urban areas is lower than that in rural areas. There were strong association rules of "kidney disease + hypertension" in urban and rural males. Male medication in urban and rural areas, high school education and above, and women 's medication in urban and rural areas were all related to the coexistence of one disease (P<0.05). The age and exercise of women in urban and rural areas, the medication of men in urban and rural areas, and the education level of high school and above were related to the coexistence of the two diseases (P<0.05). The age, exercise status, medication status of urban males and urban and rural females, and the education level of high school and above of urban and rural males were all related to the coexistence of three or more diseases (P<0.05) .

The comorbidity rate of elderly hypertensive patients in urban areas was higher than that in rural areas in Anshun city. The main comorbidity mode was "obesity+dyslipidemia / diabetes+hypertension". Age, medication, exercise and d education level are the influencing factors of hypertension comorbidity in the elderly. Strengthen the health monitoring of elderly patients with hypertension, strengthen the patient 's awareness of comorbidities, implement urban and rural differentiated comorbidity prevention strategies and measures, and improve the level of comorbidity prevention and treatment.

The multimorbidity in the elderly has become an important issue that needs urgent attention in the field of public health. Therefore, it is of great significance to explore the influencing factors of multimorbidity in the elderly.

To investigate the prevalence of multimorbidity and related influencing factors in the elderly population in northern and southern China, in order to better manage and intervene the development and prognosis of multimorbidity in the elderly in different regions.

PubMed, Embase, Web of Science, Cochrane Library, Scopus, China Biology Medicine Disc, China National Knowledge Infrastructure, Wanfang Data Knowledge service platform were searched for relevant studies on influencing factors of multimorbidity in the elderly. Two researchers independently searched, screened, extracted data, and cross-checked. Any disagreements were resolved through consultation with a third researcher for arbitration. The search time limit was from the establishment of the database to July 2024. Stata 18.0 software was used for meta-analysis.

The research incorporated 10 articles from the southern region and 10 from the northern region, with sample sizes of 2 342 507 and 75 871 cases, respectively. The prevalence of multimorbidity among elderly patients in the southern and northern regions was 34% (95%CI=29%-38%, P<0.001) and 36% (95%CI=22%-50%, P<0.001), respectively. Among them, the influencing factors of elderly patients with multimorbidity in southern China were age (OR=1.92, 95%CI=1.26-2.94, P=0.003), gender (OR=1.51, 95%CI=1.03-2.21, P=0.034), and household per capita monthly income (OR=1.62, 95%CI=1.03-2.54, P=0.036), education level (OR=1.47, 95%CI=1.25-1.73, P<0.001), BMI (OR=1.72, 95%CI=1.52-1.96, P<0.001), smoking (OR=1.53, 95%CI=1.11-2.11, P=0.009), drinking (OR=1.39, 95%CI=1.26-1.54, P<0.001), regular physical exercise (OR=0.67, 95%CI=0.55-0.80, P<0.001) ; age (OR=1.67, 95%CI=1.00-2.79, P=0.048), BMI (OR=2.39, 95%CI=1.80-3.18, P<0.001), drinking (OR=1.63, 95%CI=1.32-2.02, P<0.001), regular physical exercise (OR=0.84, 95%CI=0.71-0.99, P<0.037) were the influencing factors of elderly patients with multimorbidity in northern China. Sensitivity analysis showed that the results of Meta-analysis were stable, and Egger's test (multimorbidity prevalence: P=0.826; influencing factors: P=0.841) suggested that the risk of publication bias of the included literature was not significant.

The prevalence of multimorbidity among the elderly was relatively high in both the northern and southern regions. The risk factors for multimorbidity in both regions included: age≥70 years, overweight or obese BMI status, and alcohol consumption. Conversely, regular physical exercise served as a protective factor. In southern China, male sex, household per capita monthly income≥¥2 000, education below college level, and smoking were the risk factors for multimorbidity. These disparities may stem from dietary habits, economic levels, lifestyle pace, and uneven medical resource distribution. Enhancing inter-regional medical resource coordination and sharing is advised to improve health equity and resource balance, boosting elderly health overall. Additionally, healthcare providers should tailor interventions based on these factors to optimize disease management in elderly with multimorbidity.

With the accelerating global aging population, the burden of neurodegenerative diseases continues to rise, placing substantial economic and caregiving pressure on both society and families. Non-invasive neuromodulation (NINM) has emerged as a potential intervention, demonstrating unique advantages in mitigating functional decline. However, a scientific, comprehensive, and standardized system is still lacking in the current evaluation of effects and efficacy, as they rely heavily on subjective scales, overlook the dynamic changes of brain function, and involve ambiguous safety thresholds, thereby constraining comprehensive assessment of the long-term efficacy and clinical benefits of NINM. Based on evidence-based medicine, domestic and international guidelines, expert consensus, clinical practical experience, and technical management standards, this consensus statement proposes 11 recommendations for NINM interventions targeting elderly individuals with disability and dementia. These recommendations systematically encompass key domains including patient selection, intervention strategies, efficacy and effectiveness evaluation, and safety monitoring. The development of this consensus aims to enhance the scientific rigor and feasibility of clinical application, providing standardized guidance for NINM interventions in elderly populations with disability and dementia, thus ensuring their rational implementation and effective management in clinical practice.

There are many tools used to measure social capital of the elderly at home and abroad, However, studies evaluating its quality are rarely seen.

This study systematically evaluated the methodological quality and measurement characteristics of these tools, so as to provide reference for the selection of assessment scales.

On July, 2023, we searched studies about the measurement characteristic evaluation of the social capital scales by following database, including CKNI, Wanfang database, VIP database, PubMed, Scopus, Web of Science, CINAHL. The search time limit was until July 10, 2023. Data were extracted independently by two researchers. Based on the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines, the methodological quality and measurement properties of the included measurement tools were evaluated to form final recommendations.

A total of 15 studies were included, comprising 13 social capital assessment tools. These scales include: Social Capital Scale for Older Adults in Nursing Institutions, Health-Related Social Capital Scale for Urban New Migrants, Social Capital Scale for Middle-Aged and Older Adults Social Capital Scale for Older Patients with Chronic Diseases in Rural-to-Urban Resettled Communities, Resource Generator Scale for Rural Older Adults, Social Capital Scale for Community-Dwelling Older Adults, Social Capital Scale for Older Adults, Social Capital Questionnaire (SCQ) , Personal Social Capital Scale (PSCS) , 16-Item Personal Social Capital Scale (PSCS-16) , 8-Item Personal Social Capital Scale (PSCS-8) , Social Capital Scale for Community-Dwelling Older Adults, Onyx and Bullen Social Capital Scale. None of which reported measurement error and responsiveness of the scales. Since there have not gold standard for social capital measurement tools, criteria validity, hypothesis testing for construct validity have not been evaluated. Existing scales lack content validity evaluation, and evaluation methods differ in cross-cultural validity and stability. All off scales were rated as category B recommendations.

The measurement characteristics of social capital scale for elderly in nursing homes was comprehensively, however, its measurement items were set for specific scenarios, the application range is limited. The social capital scale of elderly can be applied to the elderly population, but the measurement characteristics should be further validated in the future.

China's population aging intensifies, and the prevalence rate of chronic diseases among middle-aged and old people is rising sharply. The comorbidities of chronic diseases are closely related to the impaired health of middle-aged and elderly people, threatening the health of middle-aged and elderly people. However, at present, there are few relevant studies on the middle-aged and elderly groups in Ningxia.

To explore the relationship between multiple chronic conditions and health impairment in middle-aged and elderly people in Ningxia.

From June to August 2022, a multi-stage stratified random sampling method was used to select 2 000 middle-aged and elderly people from 10 districts (counties) in Yinchuan City, Shizuishan City and Guyuan City of Ningxia Hui Autonomous Region for a questionnaire survey. The questionnaire covered three parts: basic information of middle-aged and elderly people, the prevalence of chronic diseases, and the situation of health impairment. The Logit model and propensity score matching (PSM) were used to analyze the impact of chronic disease comorbidity on health impairment among middle-aged and elderly people in Ningxia region.

A total of 1 997 valid questionnaires were collected, with an effective recovery rate of 99.85%. The prevalence of multimorbidity among middle-aged and elderly people in Ningxia was 20.93% (418/1 997) , and the prevalence of health impairment was 12.52% (250/1 997) . There were statistically significant differences in the prevalence of health impairment among middle-aged and elderly people with different genders, ages, marital statuses, educational levels, living alone status, smoking history, weekly exercise frequency, per capita annual household income, and whether they had received economic support from their children (P<0.05) . The Logit model results showed that gender, age, educational level, drinking history, weekly exercise frequency, and multimorbidity were the influencing factors of health impairment among middle-aged and elderly people (P<0.05) . Compared with non-multimorbid individuals, the probability of health impairment among multimorbid middle-aged and elderly people was 6.6% higher. After controlling for other factors that could affect the health impairment of middle-aged and elderly people, the average treatment effect of multimorbidity on health impairment was 0.246.

The coexistence of chronic diseases among middle-aged and elderly people increases the risk of health impairment. To reduce the risk of health impairment among middle-aged and elderly people, efforts should be made to enhance the prevention, treatment and publicity of chronic disease coexistence, and raise their awareness of self-management of chronic disease coexistence.

China entered an aging society in 1999, characterized by rapid growth rate, large population base, and the distinctive pattern of "aging before affluence". The intensifying aging trend poses significant challenges to the pension system, making the implementation of elderly health management a scientifically sound response strategy. As gatekeepers of primary healthcare, general practitioners play a pivotal role in advancing elderly health management and implementing the "comprehensive health management" philosophy, serving as the primary force in addressing aging-related challenges.

This study investigated the dynamic geographical distribution and equity disparities in the allocation of geriatric general practitioner human resources across China from 2012 to 2021, while analyzing the influencing factors of human resource allocation levels. The findings aim to provide evidence-based references for policymakers to formulate scientific human resource allocation strategies for elderly healthcare services.

This study collected relevant data from the China Statistical Yearbook and China Health Statistics Yearbook spanning 2013 to 2022. By calculating the changing trends of Gini coefficients and Theil indices based on the total and elderly population distributions, we assessed the equity in human resource allocation of geriatric general practitioners. Furthermore, a two-way fixed effects panel model was constructed to examine the province-level allocation of general practice human resources across various regions.

During the period from 2012 to 2021, the total number of general practitioners in China increased by 325 074, with all provinces demonstrating varying degrees of growth in their general practitioner workforce. The number of general practitioners per 10 000 elderly population reached 21.66, while the Gini coefficient decreased from 0.38 to 0.33. Both the overall Theil index and its inter-group and intra-group components exhibited declining trends. The results of the panel two-way fixed effects model analysis revealed that among healthcare resources: the number of nurses exerted a significant negative effect, whereas bed capacity and licensed physicians demonstrated significant positive effects on resource allocation. Population size and aging rate showed positive associations with resource distribution. Road density exhibited a negative impact on resource allocation. However, economic development level, educational indicators, and outpatient service volume did not exhibit statistically significant effects.

From 2012 to 2021, China witnessed sustained development in the allocation of human resources for geriatric general practitioners, accompanied by progressive improvements in equity. Given this trend, policymakers should holistically consider multiple factors—including population aging rates—when formulating workforce allocation strategies for general practitioners, to achieve more scientifically grounded and rational resource distribution.

The triglyceride-glucose (TyG) index is closely related to liver diseases. However, there is a lack of studies on the association between the longitudinal TyG index trajectories and liver stiffness in the elderly population, both at home and abroad.

This study aims to analyze the association between longitudinal trajectories of triglyceride-glucose index and liver stiffness status in elderly individuals.

The population was derived from the West China Elderly Preventive and Treatment Merging Cohort, comprising 2 736 individuals who participated in three or more health examinations between 2017 and 2022. Participants were aged ≥60 years, had complete triacylglycerol and blood glucose measurements, and had no history of chronic liver disease at baseline. The group trajectory model (GBTM) was applied to establish the long-term longitudinal trajectories of the TyG index, and a binary Logistic regression model was used to analyze the association between the longitudinal trajectories of the TyG index and liver stiffness.

Among the participants, 376 individuals (13.7%) had elevated liver stiffness (LSM>7 kPa). The TyG longitudinal trajectories were divided into 5 groups, including 337 individuals (12.3%) in the low-stable group, 1 172 individuals (42.8%) in the medium-low-stable group, 921 individuals (33.7%) in the medium-stable group, 268 individuals (9.8%) in the medium-high-increasing group, and 38 individuals (1.4%) in the highest-to-medium-high group. Logistic regression analysis showed that, after adjusting for confounding factors, compared to the low-stable group, the medium-low-stable group (OR=1.94, 95%CI=1.13-3.43), medium-stable group (OR=3.04, 95%CI=1.57-5.99), medium-high increasing group, and highest-to-medium-high group (OR=3.31, 95%CI=1.02-10.36) had increased risk for elevated liver stiffness.

Elderly populations should be concerned about changes in the level of the TyG index, and when the TyG index is persistently high (≥8.78), liver health should be further examined.

Poor sleep quality in older adults is closely associated with a range of adverse health outcomes. Strengthening sleep health and rehabilitation management within existing primary healthcare for older adults can help prevent or slow the onset and progression of many chronic diseases, thereby saving substantial medical resources. However, a comprehensive sleep-rehabilitation management system has yet to be established at the primary healthcare level. To address this gap, the Community Rehabilitation Working Committee of Chinese Rehabilitation Medical Association, has developed the Chinese Expert Consensus on Sleep Health and Rehabilitation Management for Community-dwelling Older Adults (2025 Edition), in collaboration with experts from multiple domestic institutions. Grounded in evidence-based research on sleep rehabilitation and informed by multidisciplinary clinical experience, the consensus considers the current availability of community-level rehabilitation resources and future trends in primary healthcare. It offers consensus-based recommendations on age-related changes in sleep physiology, goals and requirements for sleep management, rehabilitation screening and assessment, management content, and procedural workflows. The publication of this consensus is expected to play a pivotal role in guiding primary healthcare institutions to implement standardized and evidence-based management of sleep rehabilitation in older adults.

The increasing phenomena of multimorbidity and polypharmacy in older adults with cancer predisposes them to potentially inappropriate medication (PIM), which adversely affects patient prognosis.

To systematically evaluate the prevalence of PIM in older adults with cancer.

The Cochrane Library, Web of Science, Embase, PubMed, CNKI, VIP, Wanfang Data, and CBM databases were searched to collect studies related to the prevalence of PIM in older adults with cancer, and the search period was from the inception of the databases to September 2024. The examined literature was independently screened, data extracted, and evaluated, and Stata 17.0 software was used to perform meta-analysis.

A total of 36 studies with 54 prevalence estimates were analyzed, including 95 290 patients. Meta-analysis indicated that the prevalence of PIM in older adults with cancer was 44.5% (95%CI=39.2%-49.8%). The results of subgroup analysis showed that the prevalence of PIM in older adults with cancer aged 60-70 and >70 years was 44.4% and 46.1%, respectively; the prevalence of PIM in elderly male and female patients was 40.9% and 42.5%, respectively; the prevalence of PIM in patients with ≤5 and >5 diseases was 34.4% and 47.1%, respectively; the prevalence of PIM in patients with≥5 and <5 medications was 39.9% and 30.4%, respectively; the prevalence of PIM in patients with lung cancer, gastrointestinal cancer, hematologic malignancies, breast cancer, and prostate cancer was 45.6%, 39.4%, 42.0%, 39.4%, and 42.6%, respectively; the prevalence of PIM among older adults with cancer in Asia, Europe, North America, and South America was 50.2%, 45.8%, 35.7%, and 51.4%, respectively; the prevalence of PIM in patients from hospitals, databases, Dana-Farber Cancer Institute, and cancer centers was 47.6%, 43.0%, 34.6%, and 34.5%, respectively; the prevalence of PIM screened by the Beers criteria, DAE, STOPP/START criteria, EU (7) -PIM list, and the 2017 Chinese criteria was 46.6%, 16.5%, 44.6%, 60.0%, and 39.3%, respectively; the prevalence of PIM published in 2020 and before and after 2020 was 36.1% and 52.5%, respectively.

The prevalence of PIM is relatively high in older adults with cancer, at 44.5%. The prevention, screening, and intervention of potential inappropriate medication among relevant populations should be emphasized to lay a solid foundation for the health in older adults with cancer.

Acute ST-segment elevation myocardial infarction (STEMI) has a high mortality and disability rate. Percutaneous coronary intervention (PCI) is an important revascularization method that can improve prognosis. However, some patients experience recurrent angina after PCI, which affects their quality of life and long-term prognosis. Drug-metabolizing enzyme gene polymorphisms influence drug efficacy and adverse reactions. Cytochrome P450 2C19 (CYP2C19) is involved in the metabolism of multiple drugs, and its gene polymorphisms can alter enzyme activity and affect drug metabolism. The correlation between different CYP2C19 metabolic levels and recurrent angina after PCI in STEMI patients is worth exploring.

To investigate the correlation between different CYP2C19 metabolic levels and recurrent angina after PCI in STEMI patients.

A total of 128 patients who underwent emergency PCI for acute coronary occlusion at the Chest Pain Center of the First Affiliated Hospital of Inner Mongolia Medical University in 2022 were selected as the study subjects. The patients' medical records and CYP2C19 gene test results were collected. Follow-up was conducted via telephone or outpatient visits at 1, 3, 6, and 12 months after PCI, with the follow-up ending on December 31, 2023. The endpoint event was angina attack. Lasso regression analysis was used to screen variables related to angina attacks, followed by the construction of a predictive model using multivariate Logistic regression analysis and the development of a nomogram. Bootstrap resampling was used for internal model validation. The training and validation sets were evaluated using receiver operating characteristic (ROC) curves, goodness-of-fit tests, calibration curves, and decision curve analysis (DCA) to construct a risk prediction model for recurrent angina after PCI in elderly STEMI patients.

A total of 128 patients were included, with 92 males (71.9%) and 36 females (28.1%), and a median age of 63.5 (61.0, 66.0) years. During follow-up, 45 patients (35.2%) experienced recurrent angina, while 83 patients (64.8%) did not. There were statistically significant differences in gender, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and CYP2C19 genotype between patients with and without recurrent angina (P<0.05). Lasso regression analysis identified 7 independent predictive variables, including gender, LDL-C, HDL-C, homocysteine (Hcy), apolipoprotein B (ApoB), D-dimer, and CYP2C19 genotype. Multivariate Logistic regression analysis showed that female gender (OR=3.492 9, 95%CI=1.288 8-10.010 1), elevated LDL-C (OR=3.123 7, 95%CI=1.685 9-6.348 4), and elevated Hcy (OR=1.061 4, 95%CI=1.028 8-1.103 6) were risk factors for recurrent angina after STEMI intervention, while elevated HDL-C (OR=0.016 7, 95%CI=0.000 9-0.209 1), intermediate CYP2C19 metabolism (OR=0.273 4, 95%CI=0.0747-0.923 7), and normal CYP2C19 metabolism (OR=0.086 7, 95%CI=0.025 5-0.256 1) were protective factors against recurrent angina after PCI in STEMI patients (P<0.05). The model was internally validated using Bootstrap resampling with 1 000 replications, and the Hosmer-Lemeshow calibration curve showed good model fit. ROC curves were plotted for the training and validation sets, with areas under the ROC curve (AUC) of 0.869 (95%CI=0.796-0.943) and 0.789 (95%CI=0.701-0.877), respectively, indicating good discrimination in both the modeling and validation populations. Further DCA showed that the model had good clinical utility.

Intermediate and normal CYP2C19 metabolic types are protective factors against recurrent angina after STEMI intervention. This study established a risk prediction model for recurrent angina after PCI in STEMI patients that includes five clinical indicators: female gender, LDL-C, Hcy, HDL-C, and CYP2C19. The model can be used to predict the risk of recurrent angina in patients for early screening and has good fit, discrimination, and clinical application value.

Chronic disease management is a major challenge in an aging society, and medical union is a powerful way to solve the problem of chronic diseases in the elderly in China. At present, existing studies have summarized the management practice of medical union and the needs of elderly patients with chronic diseases, and relevant institutions and experts organized by government departments have also formulated corresponding guidelines and technical scheme. However, from the perspective of disease management, the matching status of specific management content from the three perspectives of guideline recommendation evidence, practice status and patient needs should be further studied.

To clarify the evidence resources of elderly chronic disease management in the medical alliance and analyze the matching status between service resources and service needs from the perspectives of "Guidance-Practice-Need".

Framed by the Arksey and O&apos;Malley scoping review framework, an analysis was conducted on the management of two diseases (hypertension and diabetes) from Jonuary 2023 to April 2024. The relevant guidelines or technical schemes from inception to December 2020 and other types of literature from August 2011 to December 2020 on the management of elderly chronic diseases (hypertension, diabetes) in the medical alliance was systematically retrieved. After removing duplicate and screening, the data were extracted, and the management content and responsible organizations were summarized by descriptive method and content analysis method, and the matching status between service resources and service demands was compared with the presentation of tables, graphs and summary paragraphs.

A total of 35 articles from 14 provinces and regions were included, covering 39 items of management content in 12 categories. Nine guidelines and technical plans literatures were included to describe 19 items of management content in 6 categories, 21 literatures on practice status introduced 24 items of management content in 9 categories, and another 6 literatures analyzed 32 items of patient needs in 12 categories. There were great differences in management content under the 3 perspectives, and the main responsible organizations of the two perspectives of guidance and practice were different.

The matching results of supply and demand of management content suggest that future research can explore the efficient utilization path of independent service resources of chronic disease management in demand-oriented medical alliances, while the matching results of responsible institutions of specific management content suggest that future research should explore how to optimize the resource allocation of primary medical institutions on the basis of strengthening the two-way referral channel, and determine the responsibility of patients and families to participate in chronic disease management.

Frailty is a syndrome that is closely related to age. Current assessment of frailty relies mainly on single inflammatory factors or nutritional indicators and lacks systematic diagnostic markers. Chronic inflammation and nutritional status as part of the physiopathologic mechanisms of debilitation, and platelet count and nutritional status are simple and easily accessible, whereas there are fewer studies on the correlation between mixed inflammatory markers of platelet count and nutritional status and frailties.

To investigate the correlation between preoperative platelet count/albumin ratio (PAR) and new-onset frailty at 7 d postoperatively in elderly patients undergoing elective surgery.

This is a secondary study based on the Early Warning Model Construction Study of EPAE dataset. Using cross-sectional survey method was used to select elderly patients who were hospitalized and planned to undergo surgery in 7 hospitals, including the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Shunde Hospital of Guangzhou University of Chinese Medicine, the Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, the Eighth Clinical Medical College of Guangzhou University of Chinese Medicine, Huizhou Hospital of Guangzhou University of Chinese Medicine, Guangzhou University of Chinese Medicine Affiliated Zhongshan Hospital of Chinese Medicine and Dongguan Hospital of Guangzhou University of Chinese Medicine from February 2023 to October 2023. A total of 2 035 patients who were non-frailty before surgery were included, and the patients were divided into a non-frailty group (1 691 patients) and a new-onset frailty group (344 patients) according to the diagnostic criteria of the Chinese version of the Frail Scale at 7 d after surgery. General data and factors affecting perioperative frailty were collected and compared between the two groups. PAR was divided into four levels according to quartiles: Q1 (PAR≤4.160), Q2 (PAR: 4.161-5.339), Q3 (PAR: 5.340-6.479) and Q4 (PAR≥6.480), multi-model multifactorial Logistic regression analysis to assess the effect of different PAR levels on frailty. Analyzing the incidence of new-onset frailty 7 days after surgery in different age groups and receiver characteristic ROC curves were plotted to calculate the area under the curve (AUC) and the optimal cut-off value to assess the predictive value of preoperative PAR on new-onset frailty in elderly patients at 7 d postoperatively.

The age, caregiver, sedentary behavior, weekly hours of aerobic exercise, weekly hours of resistance training, proportion of stress history, age-corrected Charlson Comorbidity Index (ACCI) score, Athens Insomnia Scale (AIS) score, Depression Screening Scale (PHQ-9) score, Social Support Rating Scale (SSRS) score, American Society of Anesthesiologists (ASA) classification, preoperative analgesia, mode of anesthesia, proportion of type of surgery, duration of surgery and intraoperative transfusion were compared between the non-frailty group and the new-onset frailty group. The difference was statistically significant (P<0.05) and the PAR of the new-onset frailty group was significantly higher than that of the non-frailty group (P<0.001). The results of multifactorial Logistic regression analysis showed that after adjusting for all confounders, high level of PAR was a risk factor for new-onset frailty at 7 d postoperatively in elderly patients (OR=1.22, 95%CI=1.16-1.29, P<0.001). The results of multivariate Logistic regression analysis of different levels of PAR showed that compared with Q1 level PAR, Q2, Q3 and Q4 levels were the risk factors for new frailty at 7 days after surgery in elderly patients after adjusting for all confounding factors, and the risk of new frailty at 7 days after surgery was the highest in the Q4 group (OR=6.06, 95%CI=3.90-9.41, P<0.001). Stratified analysis showed that the incidence of postoperative new-onset frailty in different age groups increased significantly with higher preoperative PAR (P<0.001), and the AUC of preoperative PAR for predicting new-onset frailty at 7 d postoperatively in elderly patients was 0.635 (95%CI=0.606-0.665, P<0.001), and the optimal cut-off value was 4.345, with a sensitivity and specificity of 89.20% and 31.20%.

High level of PAR is a risk factor for new-onset frailty at 7 d postoperatively in elderly patients. Preoperative PAR has a certain predictive value for postoperative new frailty in elderly patients, and higher PAR indicates greater risk of postoperative new frailty.

The accelerated aging process, combined with the increase in widowhood and social isolation, has led to a rise in chronic diseases, further increasing the social burden.

To explore the association between the marital status of older adults and the prevalence of cognitive impairment, as well as the impact of social support and lifestyle on this association.

A total of 9 466 older adults aged 65 years and above from Wuhan and Xiaogan, Hubei Province, were included in this study from 2018 to 2023. Participants were categorized into a married group (n=7 055) and an unmarried group (n=2 411) based on their marital status. Baseline information was collected through structured questionnaires, and cognitive function was assessed using the Mini-mental State Examnation and the Montreal Cognitive Assessment-basic China (MoCA-BC). A multivariable Logistic regression model was employed to analyze the association between marital status and cognitive impairment in the overall population as well as in subgroups stratified by age and sex. Further analyses explored the independent and combined effects of marital status, social support, and lifestyle habits on cognitive impairment risk.

Compared with the elderly with spouses, no spouse was an independent risk factor for cognitive impairment (OR=1.299, 95%CI=1.227-1.376, P<0.001). Further subgroup analysis showed that never married (OR=1.679, 95%CI=1.448-1.947, P<0.001) and widowed (OR=1.282, 95%CI=1.206-1.362, P<0.001) were independent risk factors for cognitive impairment in the elderly. Gender and age stratified analysis showed that never married (OR=2.316, 95%CI=1.680-3.193, P<0.001) and widowed (OR=1.731, 95%CI=1.405-2.131, P<0.001) were independent risk factors for cognitive impairment in elderly men. Widowed was an independent risk factor for cognitive impairment in elderly women (OR=1.163, 95%CI=1.002-1.351, P=0.047). In the 65-74 years old group, never married (OR=1.953, 95%CI=1.390-2.746, P<0.001) and widowed (OR=1.315, 95%CI=1.120-1.545, P=0.001) were independent risk factors for cognitive impairment. In the ≥75 years old group, widowed was an independent risk factor for cognitive impairment (OR=1.470, 95%CI=1.238-1.747, P<0.001). Multivariate Logistic regression analysis on marital status, social support and living habits associated with cognitive impairment showed that compared with the elderly with spouse and social support and healthy living habits, the elderly with spouse and social support but unhealthy living habits (OR=1.262, 95%CI=1.169-1.363, P=0.002), spouse and no social support but healthy lifestyle (OR=1.650, 95%CI=1.479-1.841, P<0.001), spouse and no social support but unhealthy lifestyle (OR=1.777, 95%CI=1.575-2.005, P<0.001), no spouse and social support with healthy lifestyle (OR=1.284, 95%CI=1.189-1.397, P<0.001), no spouse and social support with unhealthy lifestyle (OR=1.999, 95%CI=1.768-2.260, P<0.001), no spouse and social support with unhealthy lifestyle (OR=1.999, 95%CI=1.768-2.260, P<0.001), no spouse and no social support but healthy lifestyle (OR=1.680, 95%CI=1.500-1.882, P<0.001), no spouse and no social support but unhealthy lifestyle (OR=2.422, 95%CI=2.141-2.740, P<0.001), no spouse and no social support but healthy lifestyle (OR=2.422, 95%CI=2.141-2.740, P<0.001) were at increased risk for cognitive impairment.

The prevalence of cognitive impairment, especially among older adults without spouses, notably increases, particularly for those who have never married or are widowed. Regardless of marital status, the lack of social support and unhealthy lifestyle are risk factors for cognitive impairment. This study highlights the importance of paying attention to marital status, social support, and lifestyle in the health management of older adults.